Delivering Biomedical Information Services In FY15, NLM greatly expanded the quantity and range of high quality information available to researchers, health professionals, and the public. Among the NLM's intramural programs that contribute to its national biomedical information services are the following: PubMed: PubMed, which incorporates MEDLINE, is NLM's premier bibliographic database with over 25 million references to biomedical journal articles. MEDLINE articles are indexed by experts using the Medical Subject Headings (MeSH) controlled vocabulary, updated annually. In FY15 over 785,000 new indexed citations were added. PubMed Commons, which enables authors to share opinions and other information about scientific publications, potentially helping to improve reproducibility, added comments on nearly 1,500 PubMed articles. NLM also expanded use of automated indexing technology to increase efficiency. PubMed Central (PMC): The PMC archive of over 3.6 million full-text journal articles is central to the effort to make published results of NIH-supported research publicly accessible. As of FY15, PMC services are also provided to seven other U.S. agencies to enable public access to published results of research they support. MedlinePlus and MedlinePlus en espanol: These consumer health information resources cover over 960 topics, with selected materials in more than 40 languages. MedlinePlus Connect links electronic health records to patient education information from MedlinePlus by leveraging standardized codes and vocabularies required for meaningful use. In FY15, responsive design was implemented to provide a consistent user experience from a desktop, tablet, or phone. Clinical Trials: ClinicalTrials.gov covers over 199,000 clinical research studies in 190 countries, with hundreds added weekly. It also contains summary information about trial results, including adverse effects, in accordance with the FDA Amendments Act of 2007 (PL 110-85). In FY15, more than 22,000 new trials were registered. Summary results of more than 4,000 trials were added, bringing the total to over 18,500. Toxicology and Environmental Health: Toxicology Data Network (TOXNET) is a primary reference for toxicologists, poison control centers, public health officials, physicians and other environmental health professionals, and includes databases such as TOXLINE, Toxic Release Inventory, Hazardous Substances Data Bank, ToxMap and HaxMap. K-12 resources include an environmental health website and the GeneEd resource to support genetics education. Drug Information Resources: Drug information resources include DailyMed and Pillbox. DailyMed provides medication content and labeling information from package inserts for more than 78,000 marketed drugs. Pillbox enables rapid identification of unknown solid-dosage medications based on physical characteristics and high-resolution images. Both are linked to NLM's RxNorm standard drug names. The Computational Photography Pill Identification Project is a public challenge to develop a computer algorithm that NLM can use to identify unknown pills from smartphone photos sent to an NLM database. Disaster Preparedness and Response: NLM's Disaster Information Management Research Center (DIMRC) provides access to disaster information, promotes use of libraries for disaster management, and supports uninterrupted access to critical health information resources when disasters occur, such as Ebola in FY15. DIMRC produces WISER, CHEMM, and REMM, emergency responder tools for hazardous materials (Hazmat) and chemical, biological, radiological, and nuclear incidents. Molecular Biology, Bioinformatics, and Human Genome Resources: NCBI resources include more than 40 integrated molecular biology databases and bioinformatics software tools such as GenBank, Entrez, BLAST, RefSeq, dbGAP, Genomes, PubChem, Genetic Testing Registry, and ClinVar. Continuing areas of emphasis included addressing the impact of enormous quantities of data from high throughput sequencing and microarrays; organizing phenotypic and genotypic data from genome-wide association studies; and enhancing interfaces to journal literature retrieval to facilitate search and discovery. With the CDC, FDA, and USDA, NCBI developed database and analytic tools to use high throughput sequencing to more rapidly and accurately identify pathogens causing food-borne illnesses; similar technology is being applied to develop resources for combating antimicrobial resistance. OutreachPromoting Public Awareness and Access: Consumer health websites and the NIH MedlinePlus Magazine, in English and Spanish, convey the latest useful research findings in lay language. NLM outreach programs enhance awareness of its information services, with emphasis on underserved populations, including African American, Hispanic, and Native American communities, and health professionals serving minority, rural, and inner city populations. In FY15, dozens of community-based projects were funded. Health Services Research: NICHSR promotes access to public health and health services research through such databases as: HSRProj, covering over 14,000 ongoing or recent health services research projects from about 200 funding organizations; HSRR, a database of research datasets, instruments and software relevant to health services research; and HSTAT, containing high quality evidence reports, guidelines, technology assessments, consensus statements, and treatment protocols. Structured search queries are developed to aid in searching PubMed, ClinicalTrials.gov, and HSRProj for information on health services research, comparative effectiveness, population health, health disparities, and Healthy People 2020 objectives. Advanced Information Systems and Research Tools: LHNCBC and NCBI continued to conduct research in biomedical informatics and computational biology, tested effectiveness of medical informatics interventions, and developed new scientific computing tools. To cite a few examples, researchers enhanced tools that support standards-based electronic health records; developed tools to help detect tuberculosis in chest x-rays and detect and count malaria parasitic cells in blood smears; developed open-source programming pipelines that convert CT data to 3-D printable models; enhanced the online, image-based colposcopy Teaching Tool, deployed in 134 medical residency programs; improved methods for integrated search and discovery of biomedical images and text; and provided expertise for the trans-NIH Big Data to Knowledge (BD2K) initiative to make research data more broadly available and discoverable. Health Data Standards: As the central coordinating body for clinical terminology standards within HHS, NLM provides essential tools for meaningful use of electronic health records (EHRs) and health system interoperability. NLM develops, supports, or licenses for free U.S.-wide use the key clinical terminologies (RxNorm, LOINC, SNOMED CT) designated as standards for U.S. health information exchange. The Unified Medical Language System Metathesaurus, with more than 12 million concept names from more than 170 vocabularies, is a distribution mechanism for standard code sets and vocabularies used in health data systems. In FY15, NLM enhanced its Value Set Authority Center to improve access to vocabulary value sets for CMS-required clinical quality measures and support their authors; updated key vocabulary mappings and subsets useful in achieving meaningful use; improved user support and educational resources for SNOMED CT users; further enhanced its suite of APIs for drug vocabulary; provided infrastructure to support NIH common data element initiatives; and made FDAs medical device registry and unique device identifiers publicly available.